IV Eptinezumab Shows Versatility Against Migraine

Already approved by the FDA as an intravenous drug administered periodically to prevent migraine, eptinezumab has been shown in a recent study published in JAMA to reduce migraine pain and nausea when given after the onset of the migraine.

"Among patients eligible for preventive migraine therapy experiencing a moderate to severe migraine attack, treatment with intravenous eptinezumab shortened time to headache and symptom resolution, as compared to placebo," authors Paul Winner, DO, et al. wrote in their conclusion.

However, they noted, questions still exist about the feasibility of administering eptinezumab treatment during a migraine attack, the authors wrote. They also wrote there is a need for comparison studies of IV eptinezumab versus alternative treatments for migraine attacks.

Intravenous eptinezumab is an anticalcitonin, gene-related peptide antibody, approved for migraine prevention in adults. It has an established onset of preventive efficacy on day 1 after infusion. The authors set out to evaluate the efficacy of and adverse events related to eptinezumab when initiated during a migraine attack.

The researchers conducted the phase 3, multicenter, parallel-group, double-blind, randomized, placebo-controlled trial from November 4, 2019, to July 8, 2020, at 47 sites in the United States and the country of Georgia.

Participants included 480 people between the ages of 18 and 75 years, with a greater than 1-year history of migraine and migraine on 4 to 15 days per month in the 3 months prior to screening.

The participants were treated with either IV eptinezumab, 100 mg (n = 238), or placebo (n = 242), administered intravenously within 1 to 6 hours of onset of a qualifying moderate to severe migraine. (See Winner PK, McAllister P, Chakhava G, et al. Effects of intravenous eptinezumab vs placebo on headache pain and most bothersome symptom when initiated during a migraine attack. JAMA. 2021;325(23):2348-2356. doi:10.1001/jama.2021.7665.)